Surgical procedures have evolved into a broad range of different types of operations, with patient positioning depending upon the specific procedure to be accomplished. While most general surgery is performed on a supine patient under the influence of a general anesthetic, other types of surgery require the patient to be positioned in other than a supine position, with hands and arms extended beside or tucked along the side of the patient. An example is the lithotomy position, wherein a patient is generally positioned in a modified supine position with the hips and knees flexed and the legs supported by canvas straps or stirrups, the arms and hands being placed beside the patient, often on arm boards, or loosely cradled over the lower abdomen and secured by the lower end of a blanket. Occasionally the patient may incur injury to the hands through improper positioning of the arms and hands, through pressure when a surgeon leans over and inadvertently bears against the hand, or through crush injuries when the leg portion of the surgical table is raised after the surgery is completed. During surgery a patient is unusually very vulnerable, as the patient is under anesthesia and normal pain warning reactions are blocked.
The bones and other structure of the hands are some of the more fragile components of the human body, and oftentimes inadvertent pressure upon one or both hands, can lead to damage to the hands in the form of a broken bone or pulled tendon, soft tissue, or nerve damage, in addition to transient ischemic problems due to loss of circulation. Such problems are, of course, extremely difficult for a patient, who is often bedridden after surgery and who may have no significant ability to perform any physical act other than with his or her hands and arms. Injury to a patient""s hands may deprive the patient of the only other physical activity available until the primary surgical healing process is well underway. Of course, such extra incapacity is a distraction to a positive emotional attitude of the patient during recovery. The cost of inadvertent hand and arm injuries to patients during surgery can be considerable, as the medical profession has a duty of great care during such operations, when the unconscious patient is totally at the mercy of the medical staff performing the procedure.
Accordingly, a need exists for a device which may be applied to the hand(s), wrist(s) and lower arm(s) of a patient who is to experience general anesthesia in order to isolate the extremities of the patient from compression or other damage due to inadvertent pressure upon the hands, wrists and lower arm as the patient is positioned prior to, during, and/or after a surgical procedure.
In the past certain devices have been known to locate or position a patient""s arm and hand during surgery. In this, U.S. Pat. No. 5,785,057 to Fischer, titled xe2x80x9cMedical Positioning Device,xe2x80x9d describes various embodiments of a device for immobilizing an arm of a surgical patient. The various embodiments each include a downwardly extending flange, with a lateral flange extending inwardly there from. The lateral flange is placed beneath the mattress of a surgical table, to hold the device (and the patient""s arm) immobile during surgery. This positioning device is fixed relative to the surgical table. Accordingly, a patient using this device can not be easily moved or turned as required during many preoperative, operative, and/or postoperative periods, without removing the hand(s) from the channel(s) or disassembling the apparatus.
U.S. Pat. No. 6,101,650 issued Omdal et al., titled xe2x80x9cRecessed Arm Board,xe2x80x9d describes a generally trough shaped device having a squared, U-shaped cross section with a flange extending laterally from the upper edge of one side. The flange is placed beneath the patient or a pad on the operating table with the patient""s arm being allowed to rest within the trough. No padding or upper closure is disclosed and in fact, the fingers extend beyond the distal end of the device. The Omdal et al. device like the Fischer ""057 positioning unit does not permit movement of a patent during surgery.
The foregoing noted limitations regarding previously known surgical hand, wrist and forearm positioning and isolating devices, while significant, demonstrate that room for worthwhile improvement remains.
Accordingly, it is a principal object of the invention to provide a hand, wrist and forearm device for patients during surgery, operable to isolate a patient""s hand, wrist and lower arm from inadvertent damage or injury during a surgical procedure.
It is a further object of the invention to form the hand protector with each shell having a generally elliptical lateral section wrist securing portion, widening to a generally semi-accurate longitudinal section hand enclosure portion, with the two shells being loosely hinged together.
Still another object of the invention is to provide a series of loosely fitting hinges along one side of the two shells, with a series of mutually engaging fasteners along the opposite side for securing the two shells about the wrist and hand of the patient.
An additional object of the invention is to provide a softly padded liner or cushioning within each shell half, to apply alight pressure to the hand enclosed therein and further to urge the two shell halves outwardly to stabilize the assembly.
Yet another object of the invention is to form the liner or cushioning of a gel pack material, with the liner or cushioning being removably installed within each shell or half.
It is an object of the invention to provide improved elements and arrangements thereof in an apparatus for the purposes described which is inexpensive, dependable and fully effective in accomplishing its intended purposes.
While the invention is specifically designed for patients who undergo surgical procedures under general anesthesia, it should be noted that the subject invention may also find worthwhile application in an intensive care, geriatric, and/or pediatric environment where isolation and control of a patient""s hand, wrist, or forearm is desired.
The present invention is a hand, wrist and lower arm device, particularly suitable for use by patients undergoing surgical procedures and subject to general anesthesia. Medical personnel do their best to ensure that no harm is done to the patient during the operation, by properly positioning arms and legs during the procedure so they are not twisted or otherwise injured during the procedure. However, oftentimes the hands, wrist and lower arms are subject to some pressure or damage as the surgeon and/or other medical staff leans over the patient during the surgical procedure. It may also be necessary to turn or reposition the patient before, during, and/or after the operation, e.g., to ensure proper drainage, etc., which may result in a limb being trapped beneath the body of the unconscious patient.
When this occurs, the anesthetized patient generally cannot move or turn normally, and in fact may be restrained to preclude damage to fresh sutures, inadvertent removal of an intravenous line, etc. Under such circumstances, circulation may be impaired for a critically long time in the trapped extremity, and/or damage may occur to the relatively small bones and relatively fragile tissues of the extremity if the hand is not properly positioned.
The present invention provides a solution to the above problem, in the form of a hand, wrist and lower arm device secures about the wrist of the patient to secure the patient""s hand, wrist and lower arms. The patient""s extremity is thus protected from crushing, twisting, and/or circulatory injury during surgery. Normally, a hand device would be applied to each hand of a patient resting in a supine position with the hands tucked beside the patient, depending upon the surgical procedure and position of the patient. However, the present hand protector invention may be applied singly to one hand, if the opposite hand is the subject of a surgical procedure.
The present hand device comprises a pair of rigid, mating shells which fit loosely together to enclose the hand, wrist and lower arm of a patient. Each shell has a generally accurate lateral section wrist securing portion, which widens to form a larger, generally semi-accurate longitudinal section hand enclosure portion. The two mating halves are generally mirror images of one another and may be formed from a common mold or form, thus simplifying manufacturing. The two halves are loosely hinged together along one edge thereof, with complementary fastener mean being provided along the mating edges opposite the hinges. The interior of each half is lined with a soft, resilient padding or cushioning material, such as gel packs, in order to preclude any contact injury to the enclosed hand against the interior of the rigid shell. The two halves secure loosely together, with the interior padding taking up the space between the interiors of the shells and an enclosed hand, waist and forearm. The padding or cushioning applies light pressure to the patient""s extremity, gently holding the hand in a loosely spread position, while simultaneously applying slight outward pressure to the outer shells, in order to stabilize the shells in their assembled configuration.